Describing characteristics clinicians believe predictive of patient reported outcomes after adult's ankle fracture – A modified Delphi study. (December 2022)

• Record Type: Journal Article
• Authors: Chan, Billy H.T.; Snowdon, David A.; Williams, Cylie M.
• Is Part Of: Musculoskeletal science and practice. Volume 62(2022)
• Publication Date: 2022-12
• Subjects: Ankle -- Fracture -- Predictive characteristics -- Patient reported outcome -- Orthopaedic -- Delphi; Manipulation (Therapeutics) -- Periodicals; Physical therapy -- Periodicals; Neuromuscular diseases -- Treatment -- Periodicals; Musculoskeletal system -- Diseases -- Periodicals; Manipulation (Therapeutics); Neuromuscular diseases -- Treatment; Physical therapy; Manipulation, Orthopedic; Musculoskeletal Diseases -- therapy; Neuromuscular Diseases -- therapy; Physical Therapy Modalities; Electronic journals; Periodicals; 615.82
• DOI: 10.1016/j.msksp.2022.102632
• Languages: English
• ISSNs: 2468-8630

Abstract

Abstract: Background: Despite explanatory studies have identified a wide range of modifiable and non-modifiable characteristics, uncertainty persists as to what characteristics are predictive of patient reported outcome following ankle fracture in adults, therefore hindering the selection of candidate variables in prognostic models without compromising the accuracy. Objective: To establish consensus-based characteristics which clinicians believe are predictive of patient reported outcomes following ankle fracture. Design: Three-round online modified Delphi survey. Methods: In Round 1, participants provided responses to open-ended questions, as to what characteristics within the first eight weeks following ankle fracture are predictive of short- (<6 months), medium- (6 months–2 years) and long-term (>2 years) patient reported outcome. Rounds 2 and 3 presented consensus and gathered agreement on statements. Results: Twenty participants answered the open-ended questions, including 13 physiotherapists and seven orthopaedic/trauma surgeons. Participants reached consensus for fracture characteristics and agreement for age, recovery of signs and symptoms, fracture management complexity, medical comorbidities, mental health status and patient journey at the short-term timepoint; agreement for age, engagement in recovery process, recovery of signs and symptoms, fracture characteristics, medical comorbidities and socioeconomic status at the medium-term timepoint; agreement for engagement in recovery process, fracture characteristics and medical comorbidities at the long-term timepoint. Conclusion: Clinicians believed in certain modifiable and non-modifiable characteristics predictive of patient reported outcome following ankle fracture. Our findings may provide insights about characteristics which can be selected in prognostic model development and future explanatory studies, allowing targeting adults at risk of developing long-standing symptoms and disability. Highlights: A three-round online modified Delphi study was conducted. Consensus of characteristics predictive of ankle fracture outcomes was attained. Targeting modifiable characteristics may improve management outcomes. Future explanatory studies are required to ascertain the predictive ability.